Disabilities

701 there was a varicose tendency, but it was not in itself an efficient cause. If either were in fact a cause of varicose

veins, " the ranks of the Army would be riddled with

after, without any warning, the patient had two major convulsions, and at the end of the second he died ; it

was all over in a matter of thirty to forty seconds. He considered that the varicosity was not Necropsy led to the conclusion that death was due to attributable to war service ; there was inherent weakness hypersensitivity to amethocaine. Bronchiectasis was of the vein before war service ; the varicosity arose present. was not aggravated thereby. during war service but The coroner, returning a verdict of death by misThe Medical Services Division of the Ministry gave a, further opinion, quoting several recognised medical adventure, said there could be no possible criticism of the hospital staff. authorities. The consensus of medical authority, stated the opinion, is that varicose veins are related to a congenital and inherited weakness of the walls of the veins Disabilities and deficiency of their valves. Marching in heavy boots or the wearing of anklets would not produce varicose veins. The Ministry maintained the view that there 54. BLINDNESS FROM RETINAL was " a real preponderance of probability to the exclusion DETACHMENT of reasonable doubt " that Mr. Wills’s disability arose BLINDNESS came to me in two stages. In the summer independently of his service and was not aggravated thereby. The appellant’s solicitors submitted further of 1945, without warning, I lost the sight of one eye. medical reports and the independent medical expert An operation was performed and I lay motionless for expressed a further opinion thereon. He noted the ten weeks ; but it did no good. On returning to my ordinimpression that some shop-girls develop varicose veins ; ary business and domestic life I found that my principal but there was no statistical evidence that the number handicap was a certain nervousness in traffic. This I was greater among those standing at the counter than overcame in the early days by resisting an inclination those in the or men who among counting-house among to stand all day at machines. Return of blood through the join the District Railway at St. James’s Park and veins was largely effected by the contraction of the instead forcing myself to go to Victoria, which involved muscles surrounding them;walking or marching, as crossing a busy thoroughfare. I used the homewardsuch, was an advantage rather than a detriment. The bound crowds as unsuspecting guides through traffic. superficial veins are not supported by muscles ; functional The only other indication of the blindness, which was inefficiency between the deep and superficial veins, caused of the right eye, was constant bruising on that side due by inherited defect, allows an incommoding varicosity to bumping into various objects.’ Now I realise how to develop as a man gets older and the vessel walls I was to have my full sight for fifty years and fortunate become less elastic. The course and the failure of operative treatment in Mr. Wills’s case made it clear that he half-sight for four. In the autumn of 1949 the retina of the left eye became suffered from such a valvular deficiency. The tribunal held that war service did not cause detached. This detachment came as suddenly as the Mr. Wills’s varicose veins ; the injurious process had first ; and despite three operations and five months in begun years before ; there was a family history ; the hospital, I am now quite blind except for a precious bit condition was congenital. The Ministry having discharged of light in one corner of the left eye when the sun is very the burden of proof on the issue of attributability to This eye is never " static " ; always there are bright. war service, the appeal on this point was disallowed. On the issue of aggravation by war service the tribunal varying lights, cloud effects, and flying saucers-in fact almost a private cinema-and this has become part of could not at first make up its mind ; later it gave Mr. Wills the benefit of the doubt, being unable to say my life. that military service played no part in causing the Looking back, it seems almost incredible that anyone deterioration. like myself who has led an active life could lie motionless On the Wallbridge appeal the judge interpreted the day and night with eyes bandaged for almost five months Wills case as establishing that if a man suffered from in a state of comparative content. I had to learn to varicose veins, or if they became manifest during war distinguish many different voices, and soon found that service, it was difficult for a tribunal to hold them people are touchy about being mistaken for someone attributable to war service unless there was some evidence else. This did not worry me unduly, but I imagine that of a supervening cause other than the ordinary conditions it might upset some patients ; and for this reason I of war service. In the absence of such supervening cause think that eye wards should be small-say, six to eight ordinary service conditions could not be regarded as beds-thus reducing the number of people with whom causing varicose veins although they might aggravate the patient comes into contact. On the other hand, to the disability. have been in a room by myself and denied the sounds of The ailments considered in connection with claims for ward life would have been intolerable. (Experience war pension range from Hodgkin’s disease, Parkinson’s convinced me, by the way, that, in an ideal eye ward, disease, and diabetes mellitus to muscular strain, anxiety bathrooms and lavatories should be very simply equipped, state, and conjunctivitis. Much medical information without obstructions of any kind.) can be studied in the official or semi-onicial Reports of I wonder if doctors and others realise the comfort and

cases."

Selected War Pension Appeals, from which the above account of the Wills case is largely derived. Death from Amethocaine inquest in Manchester on Nov. 22, a patient was reported to have died from hypersensitivity to amethocaine, which had been applied to the throat before iodised oil was introduced into the bronchi. According to medical evidence, the patient, a 31-yearold man, was believed to have bronchiectasis ; and the procedure was undertaken for the purpose of radiological examination. 6 ml. of amethocaine solution had been sprayed on the throat, and a further 2 ml. placed on a swab ; this was probably less than the amount usually employed at the Royal Infirmary, where the examination was made. Administration of the amethocaine was completed in a quarter of an hour. Soon

At

an

confidence it

the fingers of a blinded I received the greatest kindness; but sometimes nurses seemed not to have been told about the special difficulties of newly blind patients. For instance, whereas the surgeon or houseman told me what he was going to do, such as uncovering the eyes or putting in drops, a nurse seldom described the food she was giving or declared when she was leaving the bedside, thus saving me from talking to thin air. This may seem trivial, but it makes a great difference. During these five months, although always hoping, I had faced the prospect of blindness ; so when I knew I was blind it did not come as such a shock. I was saved what I am told are the common immediate reactions to blindness - first resentment and then despondency. My great wish was to get home to my flat where I knew every step. Being unable to continue my secretarial

patient by

gives when they grip

way of

leave-taking.

702 work and having no private income, I had to consider my finances. However, by letting part of the flat to two business girls and with the pension granted I am able to manage. I am glad that my flat faces on to a noisy, traffic-laden thoroughfare in west London-noisy, that is, except between the hours of 10.30 P.M. and 6.30 A.M. Sounds which I previously heard subconsciously have now become a major part of my life and help me to keep in contact with time. In the quiet of the night one can sometimes hear a boat’s siren on the river ; and that, like the works’ whistles at 8 A.M., is a joy to a Clyde-born Scotswoman. At about 4.30 A.M. in spring and summer the birds begin to sing, and then it is strange to think one is in the heart of London and that their song will soon be lost in the roar of traffic. At 5.30 the newspapers are delivered to a shop opposite, and by 6 the day’s work at that shop has begun. I have been back at home for ten weeks and can do quite a lot of housework, including baking, washing, ironing, and sewing. Some jobs-for instance, dusting high slielves-liave to be done when I am alone, as friends and relations get a bit nervous when they see me attempting what to them seems dangerous. I have been asked how I know when things are cooked. I don’t know how I know, but I do. So far my only failure has been when I attempted to make Scotch pancakes. Although I succeeded in getting the mixture on to the girdle, I could not find the pancakes to turn them over ; but these pancakes will be conquered yet. I have been twice to the theatre, thoroughly enjoying the plays ; and strangely enough I was able to depict fairly accurately the stage settings. Wireless concerts are another joy. All else apart, there is the feeling of being part of the community. I have the same feeling in a restaurant. At first I was reticent about eating in public ; but now I do not mind To me so long as there is someone to cut up the meat. seems essential to make all these efforts-and they it efforts-in the are early stages of blindness as otherwise one is apt to become self-conscious. My great difficulty is in learning Braille. I know all the letters but am slow ; and this is the only thing connected with the blindness which irritates me. (I do not even get cross when I lose things. This to me is a great wonderment, for I have always had a wee bit of impatience with any slowness, and I certainly have to go slow nowadays.) However, my Braille teacher assures me that I am making normal progress and that ,one suddenly finds Braille easy. I am, of course, spoiled by machine. having received from friends a To salve my conscience I am learning to make rugs, and while listening I can also knit and sew. The blind may sometimes seem unappreciativeof kindnesses offered and shrink from accepting invitations. Most often this is due to the fear of being a nuisance, especially when one has to be " fetched and returned." Even in the early days I could cope fairly effectively with letter writing by using raised lined paper (which can be purchased from the National Institute for the Blind) for ordinary correspondence ; for airmail letters I used this lined paper as a guide, attaching the thin airmail sheets to it by ordinary spring clothes-pegs, bulldog or paper clips being less easily manipulated. Now I am usually able to write clear and straight without any guiding lines. In many ways I feel like a child, learning something new every day and being bucked with A clock that chimes the quarters my achievements. and a Braille watch are great help ; but I still wear my small, now useless, wrist-watch, which I call my optimism." Each blinded person finds little things which help. For instance, to indicate the top side of my eiderdown I have put a small safety-pin in one corner. One should use a glove to replace a saucepan on the hot-plate of the electric cooker. I usually forget and use my bare fingers-which isn’t too good for the Braille ! -

talking-book

"

Since I was very young I have always given thanks for the beauties of the world, my home, my family and friends, the work I was able to do, my health and strength, my wholeness of body and mind, and my memories. It seems as if that was a sort of premonition ; for now that I have lost the wholeness of body, the other gratitudes I have been fortunate in are my greatest comforts. having seen quite a bit of my own country and also a few other parts of the world ; and these memories of the loveliness of sea and land are now a special joy. (I am glad of the plain, straightforward way we were taught geography when I was young, because I have a very vivid picture of the map of the world.) In my family and friends I am blessed. Since I lost my sight I have received the utmost kindness from all manner of folk met casually, including especially telephone operators and bus conductors. By conductors a blind person is treated as special cargo ; and twice lately in a peremptory voice a conductor has called " VThich gentleman is giving up his seat," without waiting for the offer which always "

comes.

That

has an added sense-is it only one"!—is true. Even in the few weeks of my blindness undoubtedly I have had the most remarkable experiences, finding with ease something I expected would be difficult to find ; changing to a pencil when the pen had run dry-though I had no way of actually knowing it was dry. In fact, so often do strange things happen like this that friends say they think I must see a little. How I wish I could ! One of the things partly lost with blindness is privacy ; one’s life is more exposed. Many people have weaknesses. In my case it is an old-maidish habit of turning back when leaving the flat to make sure that the electric power to the cooker is off ; and this weakness is now sometimes laughed at by my escort. However, the greatest loss of privacy is in the reading of correspondence ; one is apt to feel that a third person may find the chat of one’s friends a bit stupid. I have (or had) another weakness for reading my letters many times, and I still find it difficult to memorise, from a single reading, all that a letter contains. To ask a person to read a letter more than once is embarrassing-especially if the reader is one of these splendid practical people who read a letter just once anddo not hoard correspondence. The remedy for hiding this is to get letters re-read by different folk. Any fear that some people might miss out worrying or controversial parts can be overcome by the choice of readers. This brings up a very interesting phase of blindnessthe reactions of relatives and friends. These are, to me, a source of constant interest. Though everyone is extraordinarily kind the blind one often needs to exercise quite a lot of tolerance as people in their kindness and helpfulness might sometimes irritate but for one’s gratitude. I suppose we blind are in many ways more sensitive than when we had our sight. For instance, things people say, often casually, may make a deep impression; and encouragement means a great deal because even when the blinded one is making good progress in rehabilitation and putting a good face on it, his whole life is so changed that a little praise for achievements is helpful. Once I discussed with a young doctor how I would manage if I should become blind ; and he assured me that I would never be helpless or a burden; a,lso I was told that I had the courage to face whatever came. Whether or not I merited these opinions, often during the five months I lay in hospital these as well as other encouragements gave me great comfort. At that time I determined that, if I were to be blind, I would try to be one of the one

happy blind." In blindness I have found a deep loneliness, but not a depressing loneliness, because there is a oneness with something outside myself which brings content and

acceptance.